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New RAPID software enhances lifesaving stroke treatment

November 07, 2018

When a stroke hits, every moment matters. Doctors must make decisions about treatment that could have lifelong impact. Kettering Health Network physicians have access to a new, advanced diagnostic tool that allows them to evaluate blood flow and identify areas of affected tissue after a stroke. Such information early in the diagnostic stage helps to determine whether a stroke victim is a good candidate for intervention.

A stroke occurs when blood vessels become clogged and the brain is deprived of vital oxygen. Within moments, brain cells begin to die, the effects of which depend on what area of the brain is involved and how long those cells are deprived of adequate blood flow. For some patients, these blockages can be removed through an intervention procedure called thrombectomy.

A thrombectomy involves removing the blood clot blocking a major blood vessel in the brain. The procedure is through the groin, and x-rays help to guide a series of catheters through the intricate pathways of the vascular system to the affected vessel in the brain. Then a small device is used to break up the clot and remove it.

Not every patient is a good candidate for the procedure, and there are many variables that determine qualification. First, the medical team looks at the size of the obstructed blood vessel–smaller ones are not good candidates because of the surgical tool.

Next, they determine how much brain tissue is affected and what can be saved by using this procedure. Finally, any evidence of bleeding on the brain (hemorrhagic stroke) will disqualify the patient. Previously, doctors and patients had to make the decision about treatment from only a limited amount of information.

Breakthrough stroke treatment

Now, Kettering Health Network physicians have a new software, called RAPID, that works within their diagnostic systems to assist in objectively determining the course of action that will offer the best possible outcome for the stroke patient.

“When you’re able to treat a stroke sooner, you will get a better result,” said Akil Patel, MD, endovascular neurosurgeon with Kettering Health Network Brain & Spine. “But the other end is when someone comes in, and it’s been several hours. There is already brain tissue that has sustained irreversible damage, and those outcomes are less fortunate. The RAPID software helps us determine where a patient is on that spectrum.”

While performing a head CT scan to make sure there is no blood on the brain, the physician can, at the same time, use RAPID to do a study and calculate how the blood flow looks in the affected areas of the brain. The result is immediate information on what parts of the brain have suffered irreversible damage, which helps the medical team focus on tissue that can be saved.

More time, better decisions

Of course, patients will benefit most from this advanced technology. With the RAPID software, patients can be more involved in the decision-making process because there may be more time to make more objective decisions.

“When there is a clear-cut finding because of the RAPID software, and it shows that a large part of the brain is in immediate danger, we move fast,” said Dr. Patel. “Sometimes, however, we have more time because the software has shown us that some tissue is at less risk than others, and there are areas of the brain you can save. It gives doctors, patients, and families more specific information and helps them to make treatment decisions that have far more benefit in the long run.”

“In the past, if you weren’t in the hospital within three to six hours, treatment options were substantially limited, and most damage was irreversible,” Dr. Patel explained. “While it’s still extremely important for people to seek immediate treatment, the implementation of the RAPID software has allowed us to extend that timeframe up to 24 hours. This allows time for informed decisions that result in better outcomes.”